\documentclass[10pt]{report}
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\begin{document}
\begin{center}{ \Large
Canadian Mathematical Society\\
TRAVEL/EXPENSE CLAIM FORM\\}
\vspace{0.4cm}

Please consult your Committee Chair or other person responsible for
the budget in question for prior approval of your travel claim. Send
your completed form, with all required receipts to:\\ 
Canadian Mathematical Society, 209-1725 St.\ Laurent Blvd, Ottawa,
Ontario K1G 3V4
\end{center}

\begin{center}
\begin{tabular*}{\textwidth}{@{\extracolsep{\fill}}|p{5cm}|c|c|c|c|c|c|c|}
  \hline
  %\multirow{3}{*}{\footnotesize\emph{ See reverse for details on required receipts}}
  \emph{ See reverse for details on}
  & Date:
  & Date:
  & Date:
  & Date:
  &\multicolumn{3}{c|}{Totals}\\
  \emph{required receipts.}
   & \multirow{2}{*}{
    \hfill\TextField[width=\dateboxwidth,maxlen=30,name=date1,align=0]{}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\dateboxwidth,maxlen=30,name=date2,align=0]{}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\dateboxwidth,maxlen=30,name=date3,align=0]{}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\dateboxwidth,maxlen=30,name=date4,align=0]{}}
  &  \multicolumn{3}{c|}{\footnotesize (separate US from CAD expenses)} \\
   Date format: YY-MM-DD. & & & & & US & GST/HST & CAD \\
  \hline
  \multirow{2}{*}{Travel (air, train, car)}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=car1,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=car2,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=car3,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=car4,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=cadUSD,align=0]{}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=carT,align=0]{}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=carCAD,align=0]{}}\\
  & & & & & & & \\\hline
  \multirow{2}{*}{Taxis (receipt required)}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=taxi1,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=taxi2,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=taxi3,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=taxi4,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=taxiUSD,align=0]{}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=taxiT,align=0]{}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=taxiCAD,align=0]{}}\\
  & & & & & & & \\\hline
  Accomm {\footnotesize (basic room and taxes only)}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=acc1,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=acc2,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=acc3,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=acc4,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=accUSD,align=0]{}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=accT,align=0]{}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=accCAD,align=0]{}}\\
  {\footnotesize (\$20 per day for private accomm.)} & & & & & & & \\\hline
  \multirow{2}{*}{Breakfast: \$10.00 per day}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=brk1,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=brk2,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=brk3,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=brk4,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=brkUSD,align=0]{}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=brkT,align=0]{}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=brkCAD,align=0]{}}\\
  & & & & & & & \\\hline 
  \multirow{2}{*}{Lunch: \$12.00 per day}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=lnch1,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=lnch2,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=lnch3,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=lnch4,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=lnchUSD,align=0]{}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=lnchT,align=0]{}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=lnchCAD,align=0]{}}\\
  & & & & & & & \\\hline
  \multirow{2}{*}{Dinner: \$30.00 per day}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=dinn1,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=dinn2,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=dinn3,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=dinn4,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=dinnUSD,align=0]{}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=dinnT,align=0]{}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=dinnCAD,align=0]{}}\\
  & & & & & & & \\\hline
  Misc {\footnotesize (receipts needed if other than per diem)}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=diem1,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=diem2,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=diem3,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=diem4,align=0]{\$}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=diemUSD,align=0]{}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=diemT,align=0]{}}
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=diemCAD,align=0]{}}\\
  Per diem: \$10.00 per day & & & & & & & \\\hline
  \multicolumn{3}{|c|}{\multirow{2}{*}{Cheques to be issued in: 
      \CheckBox[height=0.1in,width=0.1in]{CAD} \quad
      \CheckBox[height=0.1in,width=0.1in]{USD}}} & 
  \multicolumn{2}{c|}{\multirow{2}{*}{Total expenses}}  
  & \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=totUS,align=0]{}}
  &  \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=totT,align=0]{}} 
  &  \multirow{2}{*}{
    \hfill\TextField[width=\boxwidth,maxlen=30,name=totCAD,align=0]{}}\\
  \multicolumn{3}{|c|}{} &\multicolumn{2}{c|}{}   & & & \\\hline
  \multicolumn{8}{|l|}{Totals in the other currencies will be
    converted accordingly and only one cheque will be issued.}\\  
  \multicolumn{8}{|l|}{A US exchange rate is established on
    the first of every month.}\\\hline
\end{tabular*}
\end{center}

\begin{center}
  \begin{tabular*}{\textwidth}{@{\extracolsep{\fill}}|l|l|l|}
    \hline
    \multicolumn{2}{|l|}{\multirow{2}{*}{Committee / Board:\hfill\TextField[width=\stringwidth,maxlen=30,name=committee,align=0]{}}} 
    & \multirow{2}{*}{Position:\hfill\TextField[width=\stringwidth,maxlen=30,name=position,align=0]{}} \\
    \multicolumn{2}{|l|}{} & \\\hline
    \multicolumn{2}{|l|}{\multirow{2}{*}{Purpose of Trip:\hfill\TextField[width=\stringwidth,maxlen=30,name=purpose,align=0]{}}} 
    & \multirow{2}{*}{} \\
    \multicolumn{2}{|l|}{} & \\\hline
    \multicolumn{2}{|l|}{\multirow{2}{*}{Name:\hfill\TextField[width=\stringwidth,maxlen=30,name=name,align=0]{}}} 
    & \multirow{2}{*}{Signature:} \\
    \multicolumn{2}{|l|}{} & \\\hline
    \multicolumn{3}{|l|}{\multirow{2}{*}{Address:\hfill\TextField[width=2\stringwidth,maxlen=60,name=address,align=0]{}}} 
     \\
    \multicolumn{3}{|l|}{}  \\\hline
    \multirow{2}{*}{Telephone:\hfill\TextField[width=\stringwidth,maxlen=30,name=phone,align=0]{}} 
    & \multicolumn{2}{l|}{\multirow{2}{*}{email:\hfill\TextField[width=\stringwidth,maxlen=30,name=email,align=0]{}}} \\
    &\multicolumn{2}{l|}{}  \\\hline
  \end{tabular*}
\end{center}

\begin{center}
  \begin{tabular*}{\textwidth}{@{\extracolsep{\fill}}|l|l|l|l|l|}
    \hline
    \multicolumn{5}{|l|}{\small FOR OFFICE USE ONLY} \\
    \multicolumn{5}{|l|}{\footnotesize RECEIPTS: All original receipts are
      attached? YES Partially reimbursed travel receipt stamped and
      returned? YES N/A } \\\hline
    AMOUNT TO BE CHARGED & \multicolumn{2}{c|}{ CHOOSE ONE ONLY} & Approved by & Date \\ 
    AGAINST BUDGET (CAD) & PAY IN & PAY IN & (SIGNATURE) & \\ 
    & CDN FUNDS & USA FUNDS &  & \\ \hline
    \multirow{2}{*}{\$} & \multirow{2}{*}{\$}  &\multirow{2}{*}{\$}   &  & \\
     &   &  &  & \\ \hline
    \multirow{3}{*}{Charge to:}&  &  &  & \\ 
    &  &  &  & \\ 
    &  &  &  & \\ \hline
  \end{tabular*}
\end{center}

\newpage


\begin{center}
  NOTES ON EXPENSE CLAIMS
\end{center}

The CMS travel/expense budget is severely limited. It is hoped that
individuals attending business meetings who are eligible to make
expense claims will seek alternative and/or supplementary means of
support. For example, business trip can often be combined with a
research-oriented trip, and expenses can be claimed from a research
grant. Also, the individual should seek support for this trip from
his/her own institution.
\begin{enumerate}
\item
  {\bf Travel claims and submission and approval:}

  Claims should be made within one week of the completion of the trip
  and are usually processed within three weeks of receipt.

  Please complete ALL sections of the form, including the address section.

  Please consult your Committee Chair or other person responsible for
  the budget in question for prior approval (prior approvals should be
  sent to the CMS Manager, Finance and Operations at
  finances@cms.math.ca). Sending prior approval to the office ensures
  that we have the information required to evaluate and approve your
  claim without delay.

\item {\bf Travel:} Travel should be arranged using the most
  economical and practical mode as follows:
\begin{itemize}
  \item by air, using economy fare;
  \item by rail/bus;
  \item by rental car, if this is practical and economical -
    \emph{THIS MUST BE PRE-APPROVED};
  \item by privately owned vehicle within a 200 km radius of point of
    departure. In this case, the rate of reimbursement is
    35\textcent{} per km. If, by exception, a privately owned vehicle
    is used outside the 200km radius, reimbursement is made at the
    lowest of 35\textcent{} per km or the lowest equivalent airfare.
\end{itemize}
{\bf NOTE : If claiming travel by rental car or by privately owned
  vehicle (over 200 km radius), please obtain written confirmation of
  the lowest equivalent airfare from your travel agent and attach this
  to your claim.} The lack of this information may cause delays in
reimbursement.

{\bf REQUIRED RECEIPTS:} For travel by air, rail or bus, the
customer's copy of the fare ticket is required as a receipt. For
electronic tickets the electronic ticket receipt is required. Please
obtain it from your travel agent or follow the on-line instructions
for printing the receipt. {\bf Boarding passes are also required as
  proof of travel.}

{\bf Full reimbursement:} As this copy is required for the return
trip, those requesting and expecting full reimbursement of their
travel fees should submit their claim upon completion of the trip.

\item {\bf Accommodation:} 
  Expenses are based on a maximum of 2 nights' accommodation per
  business meeting. Only standard accommodation is
  reimbursed. Original receipts are required.

\item {\bf Meals:} Expenses are based on a maximum of 3 days of meals
  per business meeting. However, when meals are included in the
  meeting, air / train fare, or in the costs of registration fees, no
  claim for that meal may be made. No receipts are required.

\item {\bf Miscellaneous Expenses:} 

  The per diem allowance is meant to cover incidental expenses such as
  gratuities, laundry, dry cleaning and local telephone calls. No
  receipts are required.

  Receipts are required for any other expenses claimed here.

\item {\bf Donations to the CMS:}
  If the claimant whishes to donate a portion or all of his / her
  expenses, the travel claim form should be completed as usual,
  including all appropriate receipts. The amount of donation is to be
  written on the line under total expenses. An income tax receipt will
  be sent for donations over \$10.00 with the balance of the
  reimbursement.  All original receipts must be attached. Partially
  reimbursed receipts will be stamped and returned.  Credit card
  receipts do not qualify as receipt

\end{enumerate}
\begin{center}
  {\bf All original receipts must be attached. Partially reimbursed
    receipts will be stamped and returned.  \\Credit card receipts do
    not qualify as receipts.}
\end{center}
{\footnotesize Based on a June 30, 2010 revision.}


\end{document}

